Robotic Surgery in the Management of Renal Tumors During Pregnancy: A Narrative Review

Abstract

Renal masses are uncommon during pregnancy; they represent the most frequently encountered urological cancer in pregnant patients and require careful surgical planning. The introduction of robotic surgical systems aims to address these challenges by simplifying intra-corporeal suturing and reducing technical complexity. Robot-assisted laparoscopic renal surgery offers potential benefits over both open surgery and conventional laparoscopy, providing greater precision and reduced invasiveness, particularly in tumor excision and suturing. Although urological tumors during pregnancy are rare, early detection significantly improves outcomes by enabling intervention before the tumor advances and while the uterus remains relatively small. The decision regarding the timing and necessity of surgery in pregnant patients requires a careful assessment of maternal health, fetal development, and the progression of the disease. Risks for adverse pregnancy outcomes should be explained, and the patient's decision about pregnancy termination should be considered. Radical nephrectomy or nephron-sparing surgery are essential treatments for the management of renal tumors. Effective management demands close collaboration between a multidisciplinary team and the patient to ensure individualized care. The aim of this review was to evaluate the renal tumors during pregnancy in terms of epidemiology, risk factors, diagnosis and the safety of a robot-assisted laparoscopic approach in the management of these tumors.

Keywords: laparoscopic surgery; management; pregnancy; renal cell carcinoma; renal tumor; robotic surgery.

Figure 1

Study flow chart.

Figure 2

Robotic ports position (black triangle: robotic-8 mm trocar; white star: 12 mm trocar assistant; white circle: robotic-8 mm trocar camera position) in pregnancy during: 1st Trimester (a); 2nd Trimester (b); 3rd Trimester (c).